For years, alcohol has been a part of society’s culture, from after-dinner cheers and end-of-day after-drinks. Moderate drinking has been considered nothing more sinister. But research exposes a darker reality: if obese, with diabetes, or hypertension, your chances of developing chronic disease of the liver can be doubled, even treble, with even minimal use of alcohol.
A study published in Clinical Gastroenterology and Hepatology concluded individuals with such prevalent illnesses are more likely to develop scarring, fibrosis, and even liver failure when they use even small doses of alcohol.
As chronic disease onsets rise on the global map, understanding the relationship between alcohol and disease of the metabolism has been more urgent today.
The Mechanism of How Alcohol Damages the Liver
The liver works as the detoxification factory of the human body, transforming alcohol into nontoxic substances. But this process generates toxins, oxidative stress, and inflammation, and can kill cells of the liver.
The liver regenerates on its own under normal circumstances. But when there’s a preexisting disease, alcohol’s destructive mechanisms take root, and the probability of developing a disease of the liver becomes higher.
The Toxic Couple: Alcohol + Common Diseases
The study talks of three risk factors:
1. Excess Fat in the Stomach and Obesity
A waist circumference of 35 inches (women) and 40 inches (men) points towards dysfunction of the metabolism.
Excess fatty buildup in the stomach leads to fatty disease of the liver, and the liver has more effort digesting alcohol.
The breakdown of ethanol has precedence on the breakdown of fatty tissues, causing the buildup of fatty tissues quickly and swelling.
2. Diabetes and Glucose Disorders
Many people suffer from fatty disease of the liver even before developing diabetes.
High blood sugar forces the liver into working harder to sequester excess sugar in the way of fat, reducing its functioning capacity.
Alcohol also intensifies blood-sugar fluctuations, upping the risk of fibrosis (scar) and cirrhosis.
3. Elevated blood pressure (Hypertension)
Half of adults experience hypertension, reducing blood flow to the liver.
Alcohol also increases blood pressure, inducing more oxidation.
When compounded with obesity and diabetes, hypertension more than doubles the risk of cancer and liver failure.
This explains why disease of the liver from alcohol is more virulent in people with disease of their metabolism.
What Defines Excessive Drinking?
The study defined “heaviness of drinking” equal to:
Females: Consuming more than 0.7 ounces (20 grams) of alcohol daily
Males: Consuming more than 1.05 ounces (30 grams) of alcohol daily
For context, 0.6 ounces (14 grams) of pure alcohol equal a typical American beverage:
Red wine, 5 oz (12% alcohol)
Beer, 12 oz (5% alcohol)
Liquor, 1.5 oz (80-proof whiskey, vodka, and the like)
This translates into a woman with more-than-one glass of wine every day, and a man with two beers a day, fitting into heavy-drinking status.
Many individuals undercalculate their actual use of alcohol, and restaurant and bar servings are more generous.
A Public Crisis of Public Health: The Mounting Burden of Liver Disease
Disease of the liver ranks among the fastest-growing mortality factors in the world.
4% of global mortality can be credited to disease of the liver from alcohol (WHO)
For its part, in the United States, 1.6 million hospitalizations annually result from alcohol.
Disease of the liver mortality in young adults (ages 25-34) went up 65% in 20 years.
Apart from disease of the liver, alcohol also represents a proven human carcinogen. In January 2025, then-Surgeon General Dr. Vivek Murthy warned that alcohol contributed:
100,000 annual cases of cancer in America.
20,000 annual cancer-related mortality—far more cancer-related mortality from alcohol compared with alcohol-related automotive fatalities.
Despite this, a 2019 American Institute for Cancer Research survey identified 45% of Americans who did not know alcohol can lead to cancer.
With these on-growing health risks, experts urge governments to reassess alcohol recommendations and increase public knowledge.
How to Cut Down on Alcohol
When concerned with alcohol’s contribution towards ill-health, these evidence-driven methods can lower the amount consumed:
1. The SMART Approach
Apply SMART goals for reducing gradually, say experts:
Specific – Set a specific goal (e.g., limiting alcohol for weekends only).
Measurable – Track your drinks (and actual servings).
Achievable – Avoid risky settings where alcohol flows and flows and flows.
Relevant – Think of why reducing alcohol means better health and life.
Time-based – Set a deadline for reducing or quitting alcohol.
2. Swap for Sooner Alternatives
Replace with mocktails (alcohol-free cocktails) instead.
Replace with beverages other than beer (or wines).
Replace with sparkling water with fruits for a refreshing alternative.
3. Recognize Triggers and Create New Habits
Replace alcohol-driven events with other activities (countryside walk, exercise class, etc.).
Replace alcohol with exercise, meditation, or counseling if your trigger for alcohol use is stress.
Hang with people who foster better choices.
Conclusion: The Time for Changing Attitudes towards Alcohol and Health
For years, alcohol has been marketed as a safe social practice. But with accumulating research, we know this isn’t the reality—especially for individuals with obesity, diabetes, or hypertension.
For individuals with such disease, even small alcohol can accelerate the process of disease of the liver, inducing fibrosis, cirrhosis, and cancer of the liver. With rates of disease of the liver on the rise, the time has finally arrived for changing our attitude towards alcohol in our lives.
As individuals, we can take smart choices—whether reducing, choosing alcohol-free beverages, or giving up alcohol.
For governments and leaders, the message can be straightforward: policies on alcohol must be changed, and education must be improved, with the top priority being on public health.
Alcohol isn’t quite as innocent as we believe—and least of all for people who are already at risk.
